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Elbow Ulnar Entrapment Overview

The tissue that supplies sensation and motor function to the 4th and 5th fingers of your hand is called the ulnar nerve. This nerve travels from the cervical spine (neck region) through the shoulder and then through the inner and rear elbow area and finally to this region of the hand. As it passes through the elbow it becomes more superficial and exposed. Bumping the elbow can create a compressed nerve and a shooting pain or tingling better known as "hitting your funny bone."

A fracture or dislocation of the elbow can create irritation or significant damage to the ulnar nerve. Trauma or inflammation can create nerve compression of the ulnar nerve in the area known as the Cubital Tunnel, resulting in a compressed nerve and the consequential nerve related symptoms. This condition may also be known as Cubital Tunnel Syndrome.

Severe and chronic nerve compression can result in conductivity problems to the hand seen as tingling and weakness along the inner portion of the hand and 4th-5th fingers. Increased awareness of these symptoms may be more likely when the elbow is held in a flexed or bent position.

How Is Cubital Tunnel Syndrome Nerve Compression Diagnosed?

Your physician should be able to derive a majority of the diagnosis from the history of the problem. The symptoms of Cubital Tunnel Syndrome nerve compression are very classic and X-Ray may be negative or it may reveal bone spurring creating the nerve compression. In the event of an associated trauma, such as a fall, it will be important to rule out any bony abnormality that may be contributing to this entrapment. Additional diagnostic testing may include Nerve Conduction Velocity (NCV) or Electromyography (EMG), to determine the location and degree of the nerve entrapment.

Although Ulnar Nerve Entrapment can be more frequent in traumatic falls, the condition is also seen in medically compromised patients such as thryoid problems, alcoholics, arthritis and diabetics.

How Does The Problem Progress?

Ulnar nerve entrapment can be mild and resolved conservatively. These symptoms will be more of the sensory (numbness/tingling) variety. In more moderate to severe and chronic cases you may experience motor deficits evidenced by loss of muscle strength and size. This level of entrapment will require surgery to release the entrapped or compressed nerve and should not be allowed to persist.
 

Conservative Care

As the nerve is more easily compressed with elbow flexion and compression directly over the inner aspect of the arm, it will be important to keep the elbow straight, at least 30 degrees or less. Avoid long periods of bending and compression during sleep and make some ergonomic changes such as padding the elbow and wearing a headset for the phone.
 

Operative Care

In the event of more moderate to severe cases, surgery may be necessary, sooner rather than later. Surgical options include relocating the nerve out of the tunnel and in front of the bone. Once surgery has been performed it will be important that Physical Therapy be performed to maximize the use of the elbow, wrist and hand. This regimen will take several months after the nerve has been decompressed.\

For more information on how the nerve compression specialists at Cary Orthopaedics can help you, contact us today at 919-467-4992 for an appointment!

Cary Orthopaedics serves patients from Raleigh, Garner, Cary, Apex, Holly Springs, Fuquay-Varina, Clayton, Chapel Hill, and Pittsboro, NC